title: The effects of high thoracic epidural anesthesia on sympathetic activity and apoptosis in experimentally induced congestive heart failure.
abstract: OBJECTIVE
  To evaluate the effect of high thoracic epidural analgesia (HTEA) in congestive heart failure (CHF).
  
  
  METHODS
  Rat model of CHF.
  
  
  METHODS
  Harbin Medical University, Harbin, Heilongjiang, China.
  
  
  METHODS
  One hundred thirty-five rats.
  
  
  METHODS
  HTEA involved 5 times daily injections of 0.1% lidocaine at the T3-T4 level.
  
  
  RESULTS
  The authors examined myocardial norepinephrine (NE), angiotensin II (Ang II), endothelin-1 (ET1), and tumor necrosis factor-α (TNF-α) concentrations 2, 4, and 6 weeks after the start of HTEA. They also examined histologic changes in heart tissue and myocardial expression of apoptosis-inducing factor (AIF) and poly (ADP-ribose) polymerase (PARP). Sham rats were used as a control. In the time course, myocardial NE, Ang II, ET1, and TNF-α concentrations were significantly higher in the CHF group compared with the HTEA and sham groups (p< 0.05). Similarly, PARP and AIF protein expression levels were significantly higher in the CHF group compared with the HTEA and sham groups (p< 0.05). Microscopy revealed pronounced damage to myocardial cell structures in the CHF group; this damage clearly was reduced in the HTEA group. In addition, cardiac function evaluation indicated treatment with HTEA resulted in similar heart function as animals that did not have surgically induced CHF.
  
  
  CONCLUSIONS
  The findings suggest that HTEA induces changes in sympathetic nervous system, renin-angiotensin system, endothelial, and inflammatory process activity involved in CHF.
authors.affiliation: Department of Cardiology, First Clinical Medical College of Harbin Medical University,. Electronic address: zhaoyujuan2008@yahoo.cn.
authors.forename: Yu-juan
authors.initials: YJ
authors.lastname: Zhao
authors.affiliation: Department of Cardiology, First Clinical Medical College of Harbin Medical University.
authors.forename: Feng-qi
authors.initials: FQ
authors.lastname: Liu
authors.affiliation: Department of Cardiology, First Clinical Medical College of Harbin Medical University.
authors.forename: Chun-hong
authors.initials: CH
authors.lastname: Xiu
authors.affiliation: Department of Cardiology, First Clinical Medical College of Harbin Medical University.
authors.forename: Jie
authors.initials: J
authors.lastname: Jiang
authors.affiliation: Department of Cardiology, First Clinical Medical College of Harbin Medical University.
authors.forename: Jian-hua
authors.initials: JH
authors.lastname: Wang
authors.affiliation: Department of Cardiology, First Clinical Medical College of Harbin Medical University.
authors.forename: Yan-song
authors.initials: YS
authors.lastname: Xu
authors.affiliation: Department of Cardiology, First Clinical Medical College of Harbin Medical University.
authors.forename: Shi-ying
authors.initials: SY
authors.lastname: Fu
authors.affiliation: Centre for Cellular Morphology, Harbin Medical University, Harbin, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Huang
mesh_terms: D000767:Anesthesia, Epidural; D000779:Anesthetics, Local; D000804:Angiotensin II / Q000378:metabolism; D000818:Animals; D017209:Apoptosis / Q000187:drug effects*; D051033:Apoptosis Inducing Factor / Q000096:biosynthesis; D004260:DNA Repair; D019332:Endothelin-1 / Q000378:metabolism; D006333:Heart Failure / Q000473:pathology*; D008012:Lidocaine; D008297:Male; D009206:Myocardium / Q000378:metabolism / Q000473:pathology; D009638:Norepinephrine / Q000378:metabolism; D011065:Poly(ADP-ribose) Polymerases / Q000378:metabolism; D051381:Rats; D017208:Rats, Wistar; D013564:Sympathetic Nervous System / Q000187:drug effects*; D013904:Thoracic Vertebrae; D016707:Tissue Fixation; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism; D016277:Ventricular Function, Left
chemical_list: D000779:Anesthetics, Local; D051033:Apoptosis Inducing Factor; D019332:Endothelin-1; D014409:Tumor Necrosis Factor-alpha; D000804:Angiotensin II; D008012:Lidocaine; D011065:Poly(ADP-ribose) Polymerases; D009638:Norepinephrine
keywords: apoptosis; congestive heart failure; cytokines; high thoracic epidural analgesia; neurohumoral factors